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Striving for Fairness: A Closer Look at the NJ Comprehensive Assessment Tool

July 11th, 2018

Originally published in People & Families

On its website, the NJ Division of Developmental Disabilities (DDD) makes clear that Division-funded services for adults with intellectual and developmental disabilities are not an entitlement and are dependent on resource availability.

Those last few words are worth repeating: “dependent on resource availability.”

Each year, the New Jersey legislature distributes state funds, along with any federal dollars, to state agencies to carry out their work. For DDD, that means roughly $1.8 billion in state and federal funds. With limited resources, and a “funding pie” that is not growing as fast as the need for services, how does DDD decide who is eligible for services and how much funding each person gets?

Determining Eligibility. Determining Need.

The New Jersey Comprehensive Assessment Tool (NJCAT) is a mandatory assessment used to determine eligibility for DDD-funded services. It assesses an individual’s support needs in three main areas: self-care, behavioral, and medical. The NJCAT is a 30-40 minute questionnaire completed by parents and caregivers either online or over the phone with a representative from the Developmental Disabilities Planning Institute (DDPI) at Rutgers University. There is no paper version of the assessment tool, and once submitted, respondents cannot go back to make changes.

Responses to the NJCAT produce a score that DDD uses to establish a funding tier for an individual budget or to determine the reimbursement rate a provider will receive for that individual’s services.

According to Jonathan Seifried, Acting Assistant Commissioner of the Division of Developmental Disabilities, (DDD), the NJCAT helps achieve two significant goals: providing individuals with the services they need and ensuring consistency across the service delivery system.

“The tool is a standardized assessment that ensures individuals with similar support needs have access to similar services. It also is intended to simplify the process by streamlining multiple assessments into a single tool,” he said.

Completing the NJCAT: “You really have to know what you’re doing.”

Lisa Weissbach-Efrat, a licensed clinical social worker from Camden County, recently completed the NJCAT for her 17-year-old son, who is nonverbal. She describes him as “on the severe side of the spectrum,” with significant challenges in self-regulation. He has also has dual diagnosis of bipolar and pica, a disorder in which a person eats non-food substances with no nutritional value (i.e. wood, clothing, dirt, paper, chalk, drywall.) She believes the NJCAT score he received accurately reflect his needs, but admits that her professional experience helps when filling out such forms.

“Somebody with less experience would be at a significant disadvantage,” she said.

Although she is satisfied with the process and the results for her son, she is critical of the NJCAT.

“With someone who has intellectual disabilities or mobility issues, it is clear what they can and cannot do. For someone with autism, they may be able to do a task, but won’t. Or they may SUMMER 2018 PEOPLE & FAMILIES 41 need to be prompted or need to be redirected to do it. I had to use the ‘other’ and ‘comments’ section extensively in order to paint a clear picture of my son and the issues that we face,” she said.

Carla Johnson (*) was also satisfied with the results of the NJCAT. A professional in the field of special education, she talked to other parents before she completed the survey for her 24-year-old son with Down syndrome.

“You really have to know what you are doing when you fill it out,” she said. “It does not assess what happens if the person is left unsupervised. The question should be: ‘If left alone in the house, how long would it take for them to get into trouble,’” she joked.

Jolene Miller (*) also works in the field of special needs. Her child with Down syndrome recently transitioned into the adult system.

“The problem with the NJCAT is that families do not understand the questions. The questions ask for ‘yes’ or ‘no’ answers. I would like to see more room for families to explain their answers so that professionals can gain a clearer picture of the person in need,” she said.

She also thinks the online process is flawed and especially hard for families who do not have access to a computer.

Oscar Wright (*), a parent, believes that the questions are too general and parents do not understand how to properly answer.

“They ask a question like ‘can your child dress him or herself?’ The answer is ‘yes’ but with help. The NJCAT doesn’t allow me, as a parent, to explain that my child can dress himself only when I provide the clean clothing and fix their buttons or zipper. The question would be better stated ‘Can your child independently purchase and wash their own clothes and then dress themselves on a daily basis?’” he said.

For some families, the problems were not with the NJCAT, but with the system itself. Denise Buzz is the guardian for her 55-year-old sister, Angelique. Her difficulties came after her sister was assigned a budget of more than $212,000 per year.